Physical Therapists Opposed to OrthoNet Business Practices

Histgorically, OrhtoNet has a reputation for not approving the required amount of PT visits. We need to keep them out of the patient care equation. I feel even ASHN needs to taken out as the middle man. The right people in CPTA or APTA need to make Anthem realize that they can actually save money by eliminating these types of middlemen.

Anthem has been a bully in regards to payment and access for years. I believe this relationship with Orthonet is an egregious attempt to further restrict access and is solely motivated by greed. Medical professionals need to be in charge of your care!

Physical Therapists are the most valuable figures in the health care system at this time. They save the health care system millions of dollars each year. They deserve to be treated as the true professionals that they are, and paid fair prices by huge insurance companies for their expert services.

Insurance companies, who are money-minded and the high school educated receptionists who are their support staff do NOT have the knowledge base to make MEDICAL NECESSITY decisions. Patients are paying higher premiums for fewer services, based on decisions made by people with inadequate knowledge base. This is not right. Do you want a painter or a plumber making the decisions on what can or needs to be fixed in your car???

Orthonet-Anthem relationship is a bad idea on so many levels. Orthonet with disrupt patient care by an arbitrary review board that will be gate keeper to the health care professionals. Patients pay dearly for a insurance policy. Orthonet-anthem relationship will create another level of management that services no one.

We pay good money every month and get little in return. Pay for what is stated in the insurance contract!

Patient access to physical therapy is already challenging and OrthoNet will make it worse. Insurance companies have no business deciding what our patients need.

Practicing PT

As a PT I am appalled at the Blue Cross/Ortho net illegal actions, and unacceptable payment model.

The Blue Cross/Orthonet requirements are outrageous and unfounded!

I am a Physical Therapist who works both in a hospital as well as having my own Private Practice. I am VERY much opposed to any intermediary including OrthoNet coming between myself, my patient, and my and the physicians suggested medically necessary course of treatment. They have never seen or put hands on the patient and I am sure the physician and I who have actually seen and touched the patient can determine the medical necessity much better than someone who has never seen the patient and who has no medical background. THIS IS MALPRATICE by the intermediary by not approving (denying) what the medical practitioners have deemed medically necessary for the patient.

I think it is ridiculous to have another company partner up with Anthem to oversee Physical Therapy. I am opposed to the ortho net/Anthem relationship

Doctors don't need or want ortho net to make medical decisions on patients they have never seen. This nothing more the Anthem trying to deny medically necessary care to save money.

I am finding that more and more money is being spent on the administration/review side of health care, with less and less benefits passed to the patient who is paying for the policy and less money paid to the Medical Provider. In addition, the administrative burden in this case will be expensive for the treating physical therapist and will not enhance the efficiency or quality of care received by the patient. Please Help!!!

Insurance co.s are not looking out for the best interests of their members. They're just using delay/stall tactics to annoy us and save themselves money even though their members have these PT benefits that they paid for on their policy.

Third party middleman (OrthoNet) interference is 100% about the third party and the payer profiting from the restrictions and limitations of physical therapy. The patients and providers suffer on a multitude of levels with this structure, while the third party and the ins company continue to bank record profits. Limiting utilization does not help the subscribers in any way!

I'm tired of payors practicing Medicine without a license. Aren't you?

Medical decisions should be left to the drs and the pts not a 3rd party middleman!!!

Patients are being sold a plan that allows them to have at least 24 visits per calendar year! With Orthonet stepping in they don't even allow half of that and it's just Not Right!

when are insurance companies going to realize that by paying third party administrators that govern how many steps it will takes a physical therapist to see a physical therapy patient that causes a delay in treatment, the only one winning is the third party administrator.